QT interval and QT dispersion increase in the elderly during laparoscopic cholecystectomy: A preliminary study

Egawa, Hirotoshi; Minami, Junichi; Fujii, Kouichi; Hamaguchi, Shinsuke; Okuda, Yasuhisa; Kitajima, Toshimitsu

doi:10.1007/bf03017412

Cited by 12 publications

(21 citation statements)

References 18 publications

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“…Because of the higher intrathoracic pressures, QTd and QTcd levels may be increased more in the high-pressure group than in the low-pressure group. Although Egawa and colleagues demonstrated that QTd changes were related to the duration of CO 2 insufflation during LC, we were not able to find such a relationship [8]. Increases in the mean QTc and QTcd in our series seemed to be independent of the duration of CO 2 insufflation.…”

Section: Discussioncontrasting

confidence: 48%

“…Additionally, it is thought that surgical stress also affects QTd and QTcd [8]. Surgical exertion may prolong QT duration, but this effect was the same in both groups in our study.…”

Section: Discussioncontrasting

confidence: 40%

“…In the general patient population, prolongation of the QT interval and QTd, as shown on a 12-lead electrocardiogram (ECG), has been correlated with cardiovascular mortality [7]. In elderly persons, intraperitoneal CO 2 insufflation during LC is associated with increases in the QT interval and the QTd [8].…”

mentioning

confidence: 99%

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Effect of different intra-abdominal pressure levels on QT dispersion in patients undergoing laparoscopic cholecystectomy

et al. 2009

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Statistically significant increases of QTd and QTcd, which are associated with an increased risk of arrhythmias and cardiac events, occur during CO(2) insufflation in both high-pressure and low-pressure pneumoperitoneums. QTd and QTcd were significantly higher in the high-pressure pneumoperitoneum group than they were in the low-pressure pneumoperitoneum group. QT interval changes were not related to anesthetic agents, surgical stress, hypercapnia, or duration of CO(2) insufflation. Increased intra-abdominal pressure may have caused these changes.

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Section: Discussioncontrasting

confidence: 48%

“…Additionally, it is thought that surgical stress also affects QTd and QTcd [8]. Surgical exertion may prolong QT duration, but this effect was the same in both groups in our study.…”

Section: Discussioncontrasting

confidence: 40%

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Effect of different intra-abdominal pressure levels on QT dispersion in patients undergoing laparoscopic cholecystectomy

et al. 2009

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“…Egawa et al [26] reported that QTd prolongation was connected to the longer duration of CO 2 insufflation during laparoscopic cholecystectomy. In the present study, because of there were no significant differences between the groups relating with hypercarbia, we were not able to find such a relationship between hypercarbia and QTd, QTcd or Pd.…”

Section: Discussionmentioning

confidence: 99%

Changes on QT, Qtc and P Dispersion during Flexible Bronchoscopy under Propofol and 12121 Remifentanil Sedation. A Double-Blind Randomized Trial

Doğan¹

2012

J Anesthe Clinic Res

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Background: Serious hemodynamic alterations have been shown during flexible fiberoptic bronchoscopy (FFB). QT and P wave dispersion (QTd, Pd) may give us an significant information about cardiac status during FFB. This study aimed to compare the effect of propofol and remifentanil sedation on QTd, corrected QT dispersion (QTcd) and Pd during FFB.Method: Forty-nine ASA class I or II patients who were not pre-medicated were selected and allocated to receive either propofol 1 mg/kg (n=20) or remifentanil 1 µg/kg (n=20) and titrated to achieve Ramsey sedation score level of 5. QTd, QTcd and Pd were measured on electrocardiography baseline (T0), at the end of the infusion of drugs (T1), shortly after laryngoscopy (T2), at the end of bronchoscopy (T3) and the time of Modified Aldrete score to be achived 10 (T4) Heart rate, mean arterial pressure, respiratory rate and partial CO2 pressure in blood gas were recorded at these time points. Furthermore, recovery times (RT) were recordedResults: QTd at all measurement times, corrected QTd at T1 and T2, P dispersion at T1, T2 and T3 increased significantly in the propofol group compared to remifentanil group (p<0.05). Mean arterial pressure increased significantly in the propofol group compared to the remifentanil group at T2 (p<0.05). There was a significant decrease in respiratory rate at T1 and T3 in the remifentanil group (p<0.05). There were no significant differences in heart rate and partial CO2 pressure between groups. RT was shorter in the remifentanil group (p<0.05). Conclusion:Remifentanil shortened and propofol prolonged QTd, QTcd and Pd at sedative doses during FFB. Also we obtained the short RT with remifentanil. So remifentanil may be more suitable sedative agent during FFB.

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“…However, QT dispersion (QTD), a value obtained by subtracting the minimum QT interval from the maximum QT interval as determined using a recorded 12-lead ECG, is considered an indicator of instability during ventricle repolarization. In addition, QT and QTD appear to correlate with autonomic regulation instability [4][5][6] and are potential causes of ventricular arrhythmias [7] or severe cardiac adverse events [8], such as myocardial infarction or cardiac sudden death [9][10][11][12][13]. In addition, several reports have indicated that both values increase as a result of various perioperative surgical procedures [14,15].…”

Section: Introductionmentioning

confidence: 99%

Remifentanil can Prevent the Increase in Qt Dispersion During Modified Electroconvulsive Therapy: A Randomized Controlled Clinical Trial

Kageyama¹,

Hamaguchi²

2015

J Anesth Clin Res

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Objective: To clarify the hemodynamic-stabilizing effect of remifentanil in the context of modified electroconvulsive therapy (mECT), we measured electrocardiographic alterations in the corrected QT interval (QTc) and corrected QT dispersion (QTcD), considered predictive of ventricular arrhythmia, during mECT. Methods:Sixty patients scheduled for mECT were divided randomly into 3 groups. Patients in the low-dose remifentanil administration group (group L, N=20) were administered 0.5 μg/kg of remifentanil before mECT. Patients in the high-dose group (group H, N=20) were administered 1.0 μg/kg of remifentanil, and those in the control (group C, N=20) were administered a similar volume of normal saline solution. Modified ECT was performed in the same manner in all groups with propofol and suxamethonium. Changes in QTc and QTcD values were analyzed using a repeated measures analysis of variance, and between-group comparisons were conducted using the Bonferroni method.Results: During mECT, an increase in the mean arterial pressure, decrease in the R wave-to-R wave interval, elongation of QTc, and increase in QTcD were observed in group C, whereas these alterations were attenuated in group L and were not observed in group H. The differences observed in group C relative to the other groups were statistically significant (P<0.05). Conclusion:Compared with the control treatment and a 0.5 μg/kg dose, a 1.0 μg/kg dose of remifentanil had a preventive effect on ventricular arrhythmia after mECT, as well as on hemodynamic changes, according to the observed alterations in QTc and QTcD. Therefore, our results indicate that a 1.0 μg/kg dose of remifentanil could suppress hemodynamic changes, prevent myocardial ischemia or cerebral hemorrhage, and minimize the development of fatal arrhythmias such as ventricular tachycardia and/or ventricular fibrillation.

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QT interval and QT dispersion increase in the elderly during laparoscopic cholecystectomy: A preliminary study

Cited by 12 publications

References 18 publications

Effect of different intra-abdominal pressure levels on QT dispersion in patients undergoing laparoscopic cholecystectomy

Effect of different intra-abdominal pressure levels on QT dispersion in patients undergoing laparoscopic cholecystectomy

Changes on QT, Qtc and P Dispersion during Flexible Bronchoscopy under Propofol and 12121 Remifentanil Sedation. A Double-Blind Randomized Trial

Remifentanil can Prevent the Increase in Qt Dispersion During Modified Electroconvulsive Therapy: A Randomized Controlled Clinical Trial

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